Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment.

INTRODUCTION: Low muscle mass is a common condition in the critically ill population and is associated with adverse clinical outcomes. The primary aim of this study was to analyze the prognostic significance of low muscle mass using computed tomography (CT) scans in COVID-19 critically ill patients. A second objective was to determine the accuracy and agreement in low muscle mass identification using diverse markers compared to CT as the gold standard. METHODS: This was a prospective cohort study of COVID-19 critically ill patients. Skeletal muscle area at the third lumbar vertebra was measured. Clinical outcomes (intensive care unit [ICU] and hospital length of stay [LOS], tracheostomy, days on mechanical ventilation [MV], and in-hospital mortality) were assessed. Phase angle, estimated fat-free mass index, calf circumference, and mid-upper arm circumference were measured as surrogate markers of muscle mass. RESULTS: Eighty-six patients were included (mean age ± SD: 48.6 ± 12.9; 74% males). Patients with low muscle mass (48%) had a higher rate of tracheostomy (50 vs 20%, p = 0.01), prolonged ICU (adjusted HR 0.53, 95%CI 0.30-0.92, p = 0.024) and hospital LOS (adjusted HR 0.50, 95% CI 0.29-0.86, p = 0.014). Bedside markers of muscle mass showed poor to fair agreement and accuracy compared to CT-assessed low muscle mass. CONCLUSION: Low muscle mass at admission was associated with prolonged length of ICU and hospital stays. Further studies are needed to establish targeted nutritional interventions to halt and correct the catabolic impact of COVID-19 in critically ill patients, based on standardized and reliable measurements of body composition.

Processing and characterization of polyols plasticized-starch reinforced with microcrystalline cellulose.

Biocomposites suitable for short-life applications such as food packaging were prepared by melt processing and investigated. Biocomposites studied are wheat starch plasticized with two different molecular weight polyols (glycerol and sorbitol) and reinforced with various amounts of microcrystalline cellulose. The effect of the plasticizer type and the filler amount on the processing properties, the crystallization behavior and morphology developed for the materials, and the influence on thermal stability, dynamic mechanical properties and water absorption behavior were investigated. Addition of microcrystalline cellulose led to composites with good filler-matrix adhesion where the stiffness and resistance to humidity absorption were improved. The use of sorbitol as a plasticizer of starch also improved the stiffness and water uptake behavior of the material as well as its thermal stability. Biodegradable starch-based materials with a wide variety of properties can be tailored by varying the polyol plasticizer type and/or by adding microcrystalline cellulose filler.

Horse chestnut (Aesculus hippocastanum L.) starch: Basic physico-chemical characteristics and use as thermoplastic material.

Starch isolated from non-edible Aesculus hippocastanum seeds was characterized and used for preparing starch-based materials. The apparent amylose content of the isolated starch was 33.1%. The size of starch granules ranged from 0.7 to 35 µm, and correlated with the shape of granules (spherical, oval and irregular). The chain length distribution profile of amylopectin showed two peaks, at polymerization degree (DP) of 12 and 41-43. Around 53% of branch unit chains had DP in the range of 11-20. A. hippocastanum starch displayed a typical C-type pattern and the maximum decomposition temperature was 317 °C. Thermoplastic starch (TPS) prepared from A. hippocastanum with glycerol and processed by melt blending exhibited adequate mechanical and thermal properties. In contrast, plasticized TPS with glycerol:malic acid (1:1) showed lower thermal stability and a pasty and sticky behavior, indicating that malic acid accelerates degradation of starch during processing.

Physical, chemical and mechanical properties of pehuen cellulosic husk and its pehuen-starch based composites.

Pehuen cellulosic husk was characterized and employed as reinforcement for composite materials. In this research, thermoplastic pehuen starch (TPS) and TPS/poly(lactic acid) (PLA)/polyvinyl alcohol (PVA) composites, reinforced with 5 and 10% of pehuen husk, were prepared by melt-blending. Comparative samples of pehuen TPS and TPS/PLA/PVA blend were also studied. Physical, thermal, structural and mechanical properties of composites were evaluated. Pehuen husk mainly consists of cellulose (50 wt%), hemicellulose (30 wt%) and lignin (14 wt%). In respect to lipids, this husk has only a 0.6 wt%. Its surface is smooth and damage-free and it is decomposed above 325 °C. The incorporation of pehuen husk improved considerably the thermal stability and mechanical properties of the studied composites, mainly in TPS composites. Their thermal stability enhances since biofiber hinders the "out-diffusion" of volatile molecules from the polymer matrix, while mechanical properties could raise due to the natural affinity between husk and starch in the pehuen seed.

Preferential adhesion of silver nanoparticles onto crystal faces of alpha-cyclodextrin/carboxylic acids inclusion compounds.

Alpha-Cyclodextrin (alpha-CD) inclusion compounds containing the carboxylic acids (octanoic, decanoic, lauric or dodecanoic, myristic or tetradecanoic, palmitic or hexadecanoic and stearic or octadecanoic) as guests were synthesized and applied for preferential adhesion of silver nanoparticles (AgNPs). The binding affinity depends of the chain length of the respective guest and is most efficient for octanoic and decanoic acids. The immobilization of nanoparticles is caused by the spatial replacing of the stabilized shell of the nanoparticles by COOH groups of the guests molecules, located at the entrance of cavity of alpha-CD, corresponding to the {001} crystal plane. Crystalline coating with nanoparticles provides a means of storing of AgNPs on solids state without aggregation. The stabilization of the particles on the surface is valid for a given length and ordering of the guest in the cavities of the alpha-CD being the octanoic and decanoic acid the most appropriated.